A 5-Year-Old Boy Has a History of Recurrent Pneumococcal Pneumonia

question 8

Multiple Choice

A 5-year-old boy has a history of recurrent pneumococcal pneumonia, Pneumocystis carinii pneumonia (PCP) , and bacterial ear infections. His maternal uncle and an older brother experienced the same symptoms, but he has an older sister who is healthy. Laboratory studies indicate normal numbers of B cells and T cells, and the serum contains mostly IgM and very little IgG. Which of the following abnormalities would NOT be likely in this patient?

• A)The IgG antibodies that are present are of lower affinity for antigen than of those of a healthy individual.
• B)Lymph nodes are without well-developed follicles containing germinal centers.
• C)Macrophage killing of intracellular microbes is impaired.
• D)There is limited diversity in the repertoire of IgM antibodies produced.
• E)There is no evidence of somatic mutation of IgM variable regions.

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